Archived: The Cherries

The Cherries is a residential care home providing personal care for up to six people who may have learning disability, autistic spectrum disorder, behavioural and other complex needs. At the time of our inspection there were six people living there.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

The provider and staff were exceptionally effective at supporting people, often over long periods of time, to build confidence and respond to positive behaviour strategies. This had enabled some people to achieve personal milestone goals that profoundly improved health, lifestyle and social skills.

Some people told us the organisation went the extra mile to respond to their needs and the needs of their loved ones.

The achievements of the staff to meet some people’s needs were recognised by relatives and the provider who nominated The Cherries for a national pride award.

People received an individualised service that responded to the needs of people and their loved ones.

People and their relatives gave positive feedback about the service. People told us they decided how they spent their time and the activities they took part in.

Staff worked with people and their families, they used information from people’s histories and background to develop and review meaningful activities.

Staff monitored people’s symptoms and supported them to receive specialised medical help to ensure correct diagnoses were made and appropriate medication was available.

Staff used technology to enhance people’s care, by supporting them to use a tablet computer, access the internet and use smart TVs to view films and access music.

People were supported to take positive risks to bond and interact with family members, access the community regularly and be involved in food shopping and meal preparation. Risks were assessed and there was clear guidance and support strategies for staff to follow.

People and staff told us there were enough staff to keep people safe, support them to follow their interests and take part in activities.

People were supported to maintain a balanced diet; one person’s planned weight loss enabled them to take up new activities.

Some people had healthcare conditions that effected their eating or drinking, they were supported to manage these safely.

People, their relatives and staff were positive about the culture of the service. They felt it was transparent and well-led.

The staff were led by a management team that showed a commitment to continuous improvement and development of the service people received.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

Rating at last inspection:

At the last inspection in July 2016, the service was rated Good.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The Cherries is registered to provide accommodation and personal care for up to six people who have a learning disability and other complex needs. The Cherries is situated in a residential area of Folkestone with access to the town centre, leisure centre and public transport. Six people were living at the service at the time of inspection and each had their own personalised bedroom, two of which were ensuite. People had access to a lounge and dining area, a sitting room, a sensory room, a kitchen, two bathrooms, toilets and a large garden.

The service had a registered manager, who was also registered manager for the service located next door and who was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty to make sure people were safe and received the care and support that they needed.

Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people’s needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Some people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLS authorisations for people who were at risk of having their liberty restricted.

The care and support needs of each person were complex, and each person’s care plan was personal to them. People had detailed care plans, risk assessments and guidance in place to help staff to support them in an individual way.

Staff encouraged people to be involved and feel included in their environment. People were offered activities and participated in social activities when they chose to do so. Staff knew people and their support needs well.

Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. Staff understood people’s likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

Records were not always easy to navigate as they often contained old information that was no longer required or current. In care files this could be confusing for staff and could place people at risk of receiving care and support that did not meet their current needs. We have recommended improvements are made.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to implement improvements.

Staff told us that the service was well led and that they felt supported by the registered manager to make sure they could support and care for people safely and effectively. Staff said they could go to the registered manager and senior management at any time and they would be listened to. The registered manager had good management oversight and was able to assist us in all aspects of our inspection.

One person told us 'It's good' when we asked them about living at The Cherries. We saw that staff knew how to support people and were able to understand their needs.

We found that the service had appropriate systems in place to obtain consent in relation to people's care and support.

People's care records had been updated to include decisions and guidance for staff which helped them to support people's behaviour effectively and consistently.

We saw that people were protected from the risk of abuse. This was because staff knew how to recognise potential abuse and what action to take if they suspected abuse.

A new manager had recently taken over the day to day running of this service and the service next door, which was associated with the same provider. Staff told us the manager was available when needed. We saw that staff meetings and scheduled supervision was planned. Training records confirmed that staff had received appropriate training.

There were systems in place to regularly monitor the quality of the service.

Care was provided according to people's individual needs. Care plans showed staff how people preferred to receive support and how they communicated what they liked and disliked. People's social activities, individual interests and life skills were promoted. Care was delivered in a way that ensured people's safety and welfare. Action was taken to reduce the risk for people with challenging behaviour and with activities, such as using a trampoline and riding a horse.

Staff were supported in their roles, through supervision, training and staff meetings, which helped them to provide more effective care for people who used the service. Staff had obtained relevant qualifications, which were appropriate for their role.

People who used the service were protected from the risk of abuse. The manager and staff were knowledgeable about how to work with the safeguarding authority should there be any concerns or allegations of abuse.

People who used the service, their representatives and staff were asked for their views about their care and treatment. These were analysed and acted upon to improve the service provided.